BMC Anesthesiology最新文献

{"title":"Intraoperative hemodynamic instability and metabolic recovery are associated with early allograft dysfunction after combined liver-kidney transplantation: a single-center cohort study.","authors":"Taylan Sahin, Ali Sait Kavakli, Alaaddin Aydin, Cansu Altuntas, Eryigit Eren, Mehmet Tasdemir, Hakan Parlak, Mehmet Tokac, Fatih Ensaroglu, Ali Kocyigit, Ayhan Dinckan","doi":"10.1186/s12871-026-03875-z","DOIUrl":"https://doi.org/10.1186/s12871-026-03875-z","url":null,"abstract":"<p><strong>Background: </strong>Combined liver-kidney transplantation (CLKT) is associated with substantial intraoperative hemodynamic instability and metabolic stress. The role of modifiable intraoperative perfusion-related exposures in early allograft dysfunction (EAD) remains incompletely defined.</p><p><strong>Methods: </strong>In this retrospective cohort study, adult and pediatric CLKT recipients (2016-2025) were evaluated. Intraoperative exposures included cumulative duration of mean arterial pressure (MAP) below 65 and 55 mmHg, norepinephrine area under the curve, and serial serum lactate measurements. EAD was defined using established criteria. Discriminatory performance was assessed using receiver operating characteristic analysis, and associations were explored using logistic regression.</p><p><strong>Results: </strong>Among 25 recipients, EAD occurred in 8 (32%). Patients with EAD had significantly longer cumulative durations of MAP < 65 mmHg and higher end-of-surgery serum lactate levels. The cumulative duration of MAP < 65 mmHg demonstrated strong discriminatory performance for EAD (AUC 0.85; 95% CI 0.60-1.00), and end-of-surgery serum lactate also showed robust discrimination (AUC 0.82). Vasopressor exposure did not differ between groups. In multivariable analysis, cumulative MAP < 65 mmHg exposure showed a borderline association with EAD. Thirty-day and 90-day mortality were markedly higher in the EAD group (50% and 62.5%, respectively) compared with 0% in the non-EAD group; however, given the small number of events and complete separation between groups, these findings should be regarded as exploratory.</p><p><strong>Conclusions: </strong>EAD after CLKT is associated with sustained moderate hypotension and impaired metabolic recovery. These hypothesis-generating findings suggest that intraoperative perfusion adequacy may represent a potentially modifiable determinant of early graft function, warranting prospective validation in larger, multicenter cohorts.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of patient positioning during spinal anesthesia induction on the incidence and severity of post-dural puncture headache and hemodynamic stability: a prospective cohort study.","authors":"Geresu Gebeyehu, Adugna Aregawi, Mulatu Milkiyas","doi":"10.1186/s12871-026-03882-0","DOIUrl":"https://doi.org/10.1186/s12871-026-03882-0","url":null,"abstract":"<p><strong>Background: </strong>Post-dural puncture headache is a common complication of spinal anesthesia and can significantly affect postoperative recovery. Patient positioning during spinal anesthesia has been suggested as a potential influencing factor, although evidence remains inconsistent. This study aimed to compare the incidence of PDPH and perioperative hemodynamic changes between sitting and lateral decubitus positions.</p><p><strong>Methods: </strong>This prospective observational cohort study was conducted from January to April 2024 at a tertiary teaching hospital. A total of 84 adult, ASA I/II patients undergoing elective orthopedic surgery under spinal anesthesia were included. Patients were allocated into either sitting or lateral decubitus position based on routine clinical practice. The primary outcome was incidence and severity of PDPH assessed over five postoperative days using a visual analog scale. Secondary outcomes included changes in mean arterial pressure and heart rate. Multivariable logistic regression was used to adjust for potential confounders, including age, sex, needle gauge, and number of puncture attempts. A p value less than 0.05 was declared as a statistically significant.</p><p><strong>Results: </strong>The incidence of PDPH was significantly higher in the sitting group compared with the lateral group (23.8% vs. 7.1%, p = 0.04). Severity of headache was also greater in the sitting group, with all severe cases occurring in this cohort. After adjustment, sitting position remained associated with increased odds of PDPH (adjusted OR = 3.85, 95% CI: 1.05-14.10). Mean arterial pressure decreased in both groups after spinal anesthesia, with more pronounced early hypotension observed in the lateral group at 10 and 15 min (p < 0.01). Heart rate changes were not significantly different between groups.</p><p><strong>Conclusion: </strong>Patient positioning during spinal anesthesia was associated with differences in PDPH incidence and early hemodynamic changes. The sitting position showed a higher association with PDPH compared with the lateral position. However, given the observational design, these findings should be interpreted as associative rather than causal. Further randomized controlled studies are needed to confirm these results.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of frailty and sarcopenia index on postoperative nausea and vomiting in elderly patients undergoing sedation-assisted gastrointestinal endoscopy.","authors":"Dongxu Sun, Jinguang Zhang, Zhilin Chen, Rui Liu, Mingming Zuo, Yazhao Sun","doi":"10.1186/s12871-026-03874-0","DOIUrl":"https://doi.org/10.1186/s12871-026-03874-0","url":null,"abstract":"<p><strong>Background: </strong>Frailty and sarcopenia are age-related syndromes characterized by diminished physiological reserve and are associated with adverse health outcomes. This study aimed to investigate the combined impact of frailty and sarcopenia on postoperative nausea and vomiting (PONV) in elderly patients undergoing gastrointestinal endoscopy with sedation.</p><p><strong>Methods: </strong>This prospective cohort study enrolled 703 patients aged ≥ 60 years who underwent sedation-assisted gastrointestinal endoscopy at Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from June 2025 to December 2025. Frailty was assessed using the Fried Frailty Phenotype, and sarcopenia was evaluated using the sarcopenia index (SI). The primary outcome was the incidence of PONV. Multivariable logistic regression, considering reflux esophagitis, motion sickness history, and intraoperative hypotension, was performed, and ROC curve analyses were performed to evaluate the associations of frailty and SI with PONV.</p><p><strong>Results: </strong>The overall incidence of PONV was 31.6%. Multivariable logistic regression showed that frail patients had a significantly increased risk of PONV (OR = 3.237, 95%CI 2.287-4.594, P < 0.001). Similarly, lower SI levels were independently associated with an increased risk of PONV (OR = 0.887, 95%CI 0.799-0.982, P = 0.022). ROC curve analysis showed that frailty predicted PONV with an AUC of 0.642 (sensitivity 51.8%, specificity 76.5%), whereas SI alone showed limited discriminative ability (AUC 0.559). However, when frailty and SI were added to the base model (which included reflux esophagitis, motion sickness history, and intraoperative hypotension), the model's predictive performance significantly improved: the AUC increased from 0.587 to 0.664 (DeLong test P < 0.001), with a NRI of 0.563 (95%CI 0.404-0.721) and an IDI of 0.072 (95%CI 0.040-0.117). Employing the SI cutoff value of 6.442, we categorized patients into four groups. Using the non-frailty + high SI group as a reference, the risk of PONV increased progressively in the non-frailty + low SI group (OR = 1.760, 95%CI 1.077-2.843), frailty + high SI group (OR = 2.888, 95%CI 1.922-4.350), and frailty + low SI group (OR = 6.916, 95%CI 3.856-12.717). Interaction analysis showed a significant additive interaction between frailty and low SI on PONV.</p><p><strong>Conclusions: </strong>Frailty and low SI in elderly patients are significantly associated with an increased risk of PONV following gastrointestinal endoscopy with sedation. Although SI alone has modest discriminative ability, combining it with frailty enhances risk stratification. These findings indicate that assessing physiological reserve using the Fried phenotype and SI may improve preoperative risk evaluation and guide individualized antiemetic prophylaxis in older patients undergoing sedation-assisted endoscopy.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procedural outcomes in patients undergoing non-cardiac surgery with cardiac variant amyloidosis.","authors":"Michael A Smith, Maria A Estevez, Ryan M Chadha, Emily C Craver, Melissa A Lyle, Anna B Shapiro","doi":"10.1186/s12871-026-03869-x","DOIUrl":"https://doi.org/10.1186/s12871-026-03869-x","url":null,"abstract":"<p><strong>Background: </strong>Amyloidosis is a complex disease with a multitude of sequalae, particularly with the variants that cause cardiac amyloidosis. There is minimal literature on the types of procedures these patients undergo and the associated postprocedural outcomes. This gap of knowledge makes it difficult for anesthesia providers to risk stratify amyloidosis patients. The primary outcome was 30-day all-cause mortality. Secondary outcomes included other postoperative complications and analysis of types of procedures requiring anesthesia.</p><p><strong>Methods: </strong>This is a single-center, retrospective chart review study performed at a tertiary care medical center that serves as a referral center for patients with amyloidosis. Patients with a known diagnosis of transthyretin (ATTR) or light chain (AL) amyloidosis who underwent procedures requiring anesthesia between January 1, 2018 and October 24, 2024 were included in the study. Data analysis was performed to assess patient demographics, procedural tendency, and postoperative outcomes.</p><p><strong>Results: </strong>During the study period, 160 patients underwent a total of 466 procedures requiring anesthesia. Overall, 30-day mortality rate for all encounters was 1.7% (2.7% AL vs. 0.5% ATTR, OR 5.71). Endoscopy was the most common procedure, accounting for 26.6% of all procedures. At the patient level, several procedures were more common in ATTR patients including TEE/Cardioversions (21.7% vs. 6.6%, p = 0.008), electrophysiology (36.2% vs. 9.9%, p < 0.001), and neurosurgery (13.0% vs. 3.3%, p = 0.031).</p><p><strong>Conclusions: </strong>In conclusion, patients with amyloid variants that cause cardiac amyloidosis carry substantial postoperative risk when undergoing procedures, with a trend toward increased mortality in patients with AL compared to ATTR. Patients with ATTR are more likely to require neurosurgery and treatment of arrythmias than patients with AL. Additional studies are needed to determine specific diagnostic parameters to help optimize these patients in the future.</p><p><strong>Trial registration: </strong>Not applicable. Not a clinical trial.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmentally sustainable anaesthesia: a cross-sectional survey of anesthesiologists in teaching hospitals of Karachi, Pakistan.","authors":"Abdullah Nisar, Samie Asghar Dogar, Asiyah Aman, Fatima Nazir, Asma Abdus Salam, Alina Mahmood, Zahid Akhtar Rao, Sheema Siraj, Arsalan Jamil, Fauzia Khan","doi":"10.1186/s12871-026-03842-8","DOIUrl":"https://doi.org/10.1186/s12871-026-03842-8","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standard gastroscope-guided endotracheal intubation in the lateral position for life-threatening variceal bleeding: a report of technical feasibility and airway safety.","authors":"Xia Zhang, Chuanyu Sun","doi":"10.1186/s12871-026-03871-3","DOIUrl":"https://doi.org/10.1186/s12871-026-03871-3","url":null,"abstract":"<p><strong>Background: </strong>Patients with acute upper gastrointestinal hemorrhage (UGIH) often present with airway contamination due to hematemesis and gastric reflux. Conventional endotracheal intubation (ETI) in the supine position faces challenges such as limited visualization and high aspiration risk. While securing the airway and controlling bleeding are both critical during resuscitation, simultaneous achievement of these goals remains technically difficult.</p><p><strong>Case presentation: </strong>A 56-year-old woman with esophageal variceal rupture presented with hemorrhagic shock. After left-lateral positioning and rapid-sequence induction, a cuffed endotracheal tube pre-loaded with a J-tipped guidewire was advanced through the right channel of a bite block into the oropharynx. Under continuous direct visualization provided by a standard diagnostic gastroscope, the tube was steered into the glottis on the first attempt. The scope was then advanced through the tube into the esophagus, permitting immediate endoscopic band ligation of all bleeding varices. The entire process from securing the airway to endoscopic access was completed without apparent delay, with no clinically evident aspiration and with maintained hemodynamic stability.</p><p><strong>Conclusions: </strong>This case demonstrates the technical feasibility of standard gastroscope‑guided intubation in the lateral decubitus position for airway management in massive upper gastrointestinal (GI) bleeding with hypovolemic shock. The procedure enabled rapid airway control without repositioning‑induced hemodynamic instability, allowed seamless transition to endoscopic hemostasis, and was not associated with visible aspiration or mucosal injury. Considering the limitations of a single case, the approach may reduce risk and appears feasible in this instance. These findings are descriptive and not generalizable. The technique may be considered a potential alternative in selected high‑risk \"bloody airway\" scenarios when advanced bronchoscopic equipment is unavailable. Further validation in larger studies is needed.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of esketamine-based opioid-free anesthesia on quality of recovery after laparoscopic hysterectomy: a randomized controlled trial using the QoR-40 questionnaire.","authors":"Yufeng Chen, Peng Qin, Enqi Tian, Meiling Hu, Xixi Qin, Guoping Wang","doi":"10.1186/s12871-026-03863-3","DOIUrl":"https://doi.org/10.1186/s12871-026-03863-3","url":null,"abstract":"<p><strong>Objective: </strong>In patients undergoing laparoscopic hysterectomy, this study compared two anesthetic approaches-esketamine-based opioid-free anesthesia and opioid-based anesthesia-to assess their impact on postoperative recovery quality.</p><p><strong>Patients and methods: </strong>This prospective trial randomly assigned 91 patients undergoing laparoscopic hysterectomy to receive either esketamine-based anesthesia (induction and maintenance with esketamine, without perioperative opioids) or conventional opioid-based anesthesia. The primary endpoint was defined as the Quality of Recovery-40(QoR-40) score measured on postoperative day (POD) 1. Secondary measures comprised the QoR-40 score on POD 3, pain scores after surgery, hemodynamic variables, and adverse events.</p><p><strong>Results: </strong>On POD1, compared to the opioid group, the esketamine group exhibited a significantly elevated QoR-40 score (p < 0.001), but scores were similar by POD3 (p = 0.333). The esketamine group experienced a lower rate of postoperative nausea and vomiting (PONV) (17.8% vs. 37.0%, p = 0.040), whereas the two groups had comparable pain scores at every time point measured (all p > 0.05).</p><p><strong>Conclusion: </strong>Among laparoscopic hysterectomy patients, esketamine-based opioid-free anesthesia was linked to higher POD1 QoR-40 scores and fewer PONV events than opioid-based anesthesia. However, given the modest sample size, these preliminary findings warrant confirmation in larger multicenter trials.</p><p><strong>Trial registration: </strong>We prospectively registered the study protocol in the Chinese Clinical Trial Registry. (ChiCTR2300075661) on September 12, 2023.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental sustainability in anesthesia and operating room practice: a national multicenter survey of knowledge, attitudes, and behaviors.","authors":"Semin Turhan, Sibel Önen Özdemir, Mehmet Berksun Tutan, Güvenç Doğan, Selçuk Kayır, Arzu Akdağlı Ekici, Özgür Yağan","doi":"10.1186/s12871-026-03858-0","DOIUrl":"https://doi.org/10.1186/s12871-026-03858-0","url":null,"abstract":"<p><strong>Background: </strong>Healthcare systems contribute substantially to global greenhouse gas emissions, with operating rooms representing one of the most carbon-intensive areas of clinical practice. Although awareness of environmentally sustainable practices in perioperative care is increasing, the extent to which knowledge and attitudes are associated with sustainable behaviors among operating room professionals remains unclear.</p><p><strong>Methods: </strong>This multicenter cross-sectional survey with national scope was conducted among healthcare professionals working in operating room-related settings across Türkiye. Participants were recruited using a convenience sampling strategy. A structured, self-administered online questionnaire (based on self-reported responses) assessed knowledge, attitudes, and self-reported behaviors related to environmentally sustainable operating room practices. Knowledge, attitude, and behavior scores were analyzed as continuous variables. Correlation analyses and multivariable linear regression models were used to identify individual, professional, and institutional factors statistically associated with each domain.</p><p><strong>Results: </strong>A total of 213 participants were included. Mean knowledge, attitude, and behavior scores were 6.23 ± 2.44, 19.0 ± 6.0, and 22.0 ± 6.0, respectively. Knowledge scores were positively associated with anesthesiology-related affiliation and specific clinical exposures and inversely associated with age and years of professional experience. Attitude scores were associated with obstetric operating room experience, prior sustainability-related training, and peer- and literature-based information sources. Behavior scores were independently associated with both knowledge and attitude scores and with the reported presence of an institutional carbon footprint-related training program. The reported presence of a formal institutional carbon footprint policy was not associated with higher knowledge or attitude scores and showed a negative association with knowledge in adjusted analyses.</p><p><strong>Conclusion: </strong>Operating room professionals in this multicenter survey demonstrated limited-to-moderate awareness and generally favorable attitudes toward environmental sustainability; however, variability in self-reported sustainable practices was observed. Knowledge and institutional variables were statistically associated with behavior scores, although causal inferences cannot be made. Given the convenience sampling design and reliance on self-reported data, findings should be interpreted with caution. These findings highlight the complexity of sustainability implementation in anesthesia and perioperative care and support the need for further implementation-focused and longitudinal research.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intestinal microbiota dynamics in postoperative delirium following cardiac surgery with cardiopulmonary bypass: an observational study.","authors":"Shaoqiong Zhang, Xinyi Ma, Xiaodong Zhang, Bin Zou, Yingjie Sun, Yugang Diao","doi":"10.1186/s12871-026-03862-4","DOIUrl":"https://doi.org/10.1186/s12871-026-03862-4","url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium (POD) is a common complication of cardiac surgery with cardiopulmonary bypass (CPB), and it is associated with systemic inflammation and gut-brain axis dysregulation. This study investigated the intestinal microbiota dynamics in patients with POD undergoing CPB to identify microbiota-related biomarkers and associated mechanisms.</p><p><strong>Methods: </strong>This observational study included 48 patients who underwent cardiac valve surgery with CPB. Faecal samples were collected preoperatively and postoperatively. POD was diagnosed using the Confusion Assessment Method for the Intensive Care Unit and 3-minute Diagnostic Confusion Assessment Method within 7 days of surgery. The intestinal microbiota composition was analysed using 16S rRNA sequencing, and the alpha/beta diversity, taxonomic groups, and functional pathways were then evaluated. Perioperative variables and microbiota differences between the POD and non-POD (NPOD) groups were evaluated.</p><p><strong>Results: </strong>In patients with POD, the postoperative intestinal microbiota exhibited reduced alpha diversity (e.g., observed amplicon sequence variants, P < 0.001) and altered beta diversity (unweighted or weighted UniFrac, P < 0.001) than those in preoperative samples. Linear discriminant analysis Effect Size analysis identified 25 differentially expressed species that served as biomarkers (linear discriminant analysis score > 4). Preoperatively, no significant differences in the microbial communities were found between the POD and NPOD groups (unweighted UniFrac, P = 0.171; weighted UniFrac, P = 0.085). Postoperatively, patients with POD exhibited distinct beta diversity (unweighted UniFrac, P = 0.004; weighted UniFrac, P < 0.001), and Lactobacillaceae was identified as a protective biomarker. Further, CPB period was an independent risk factor for POD (Odds ratio, 1.06 [95% confidence intervals, 1.01-1.14]) .</p><p><strong>Conclusion: </strong>This study demonstrates significant alterations in the intestinal microbiota composition following cardiac valve surgery with CPB and reveals that Lactobacillaceae is a potential protective biomarker for POD.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect and hemodynamics of remimazolam besylate on sedation of mechanically ventilated patients: a propensity score-matched study.","authors":"Wenjie Xie, Xiaoyu Fang, Zhaokun Shi, Wei Wu, Miao Wu, Handong Zou, Shasha Wang, Huifang Wan, Guang Li, Wenfang Xia, Wenwei Gao, Zhenwen Li, Zhou Liu, Lingxia Qin, Guijun Jiang, Lu Wang, Liying Zhan","doi":"10.1186/s12871-026-03870-4","DOIUrl":"https://doi.org/10.1186/s12871-026-03870-4","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}